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远程皮肤病学与面对面皮肤病学用于黑色素瘤诊断的系统评价

Teledermatology vs. Face-to-Face Dermatology for the Diagnosis of Melanoma: A Systematic Review.

作者信息

López-Pardo Rico María, Ginarte Val Manuel, Sánchez-Aguilar Rojas María Dolores, Martínez Leboráns Lorena, Rodríguez Otero Carmen, Flórez Ángeles

机构信息

Dermatology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain.

Santiago de Compostela University, 15705 Santiago, Spain.

出版信息

Cancers (Basel). 2025 Aug 29;17(17):2836. doi: 10.3390/cancers17172836.

Abstract

BACKGROUND

Cutaneous melanoma is the leading cause of skin cancer-related mortality, and early detection is crucial to improving prognosis. Teledermatology (TD) has increasingly been adopted in melanoma care to address growing demand and limited access to specialists. This systematic review aimed to evaluate the role of TD in the diagnosis and management of suspected melanoma under real-world clinical conditions.

METHODS

The review was conducted and reported in accordance with the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Embase, Web of Science, and Scopus up to December 2024. Studies assessing TD use in routine practice were included, focusing on diagnostic accuracy, prognostic indicators, waiting times, satisfaction, and economic outcomes.

RESULTS

TD showed high sensitivity and specificity, particularly when dermoscopic images and expert interpretation were available. Some studies reported reduced Breslow thickness and shorter delays compared to face-to-face care. Overall satisfaction was high among both patients and clinicians. Economic evaluations suggested potential cost savings, although formal analyses were limited. The use of artificial intelligence tools yielded mixed results and was generally perceived with caution in the absence of clinical supervision.

CONCLUSIONS

Teledermatology appears to be a useful approach for improving access and supporting early diagnosis in melanoma care. Its effectiveness depends on proper implementation and integration into clinical workflows.

摘要

背景

皮肤黑色素瘤是皮肤癌相关死亡的主要原因,早期检测对于改善预后至关重要。远程皮肤病学(TD)在黑色素瘤护理中越来越多地被采用,以满足不断增长的需求和专科医生资源有限的问题。本系统评价旨在评估在实际临床条件下TD在疑似黑色素瘤诊断和管理中的作用。

方法

本评价按照PRISMA 2020指南进行并报告。截至2024年12月,在PubMed、Embase、Web of Science和Scopus中进行了文献检索。纳入评估TD在常规实践中应用的研究,重点关注诊断准确性、预后指标、等待时间、满意度和经济结果。

结果

TD显示出高敏感性和特异性,特别是在有皮肤镜图像和专家解读的情况下。一些研究报告称,与面对面护理相比,Breslow厚度降低,延迟时间缩短。患者和临床医生的总体满意度都很高。经济评估表明可能节省成本,尽管正式分析有限。人工智能工具的使用结果不一,在缺乏临床监督的情况下,人们通常持谨慎态度。

结论

远程皮肤病学似乎是改善黑色素瘤护理中医疗可及性和支持早期诊断的有用方法。其有效性取决于正确实施并融入临床工作流程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57e8/12427390/772053bc6132/cancers-17-02836-g001.jpg

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